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Five Things to Know About Cancer Staging

When cancer patients are diagnosed, they will be given the stage of their disease. What does the staging number mean? Two of our general oncologists at the UW Carbone Cancer Center clinic at 1 S. Park, Robert Hegeman, MD and Michael Huie, MD, fill us in. This information is generalized for all cancers, but there are exceptions, so be sure to talk to a doctor about staging related to a specific cancer type.

1. Cancers stages are numerical values, 1 to 4, and are determined based on the tumor's size and how far it has spread.

In general, stage 1 is small, localized and has not spread to any lymph nodes. These tumors are the most likely to be curable with surgery. Stage 2 tumors are larger, and there may be some lymph node involvement, meaning the cancer has started to spread from the primary site. Stage 3 usually means there is significant lymph node involvement. Stage 4 cancers have spread to another part of the body.

2. Staging varies widely between tumor types.

"The prognosis is very different for a patient who has a stage 2 lung cancer versus a stage 2 breast cancer," Huie said.

3. No two tumors are the same, even if they are the same type and same stage.

"Some stage 2 breast cancers have a very poor prognosis, and some are easily cured," Hegeman said. Added Huie, "We can determine the prognosis of an individual based on the survival rates of previous patients with the same stage and biological characteristics of their cancers, but we can't say specifically what will happen to an individual patient."

4. Stage does not equal Grade.

Grade, measured from 1 to 3, is a value of how aggressive the cancer is.

"I think this is one of the most common areas of misconception, because stage and grade mean very different things," Hegeman said. "The grade is when the pathologist looks at the cancer under the microscope and makes an assessment of how quickly it is likely to grow and spread in the future, whereas staging assesses the size and location of a cancer at the time a patient is treated."

5. Even with all the ambiguities, staging is a necessary part of a cancer diagnosis.

"Staging allows us a place to start, to see how the disease is evolving and to help determine the prognosis," Huie said. Added Hegeman, "It's a way for doctors to consistently communicate with each other and for us to know if we're proceeding in the right direction with our treatments."